With advances in breast reconstruction surgery, more than one-third of women undergoing breast removal have their breast(s) rebuilt. According to the American Society of Plastic Surgeons, in 2004 more than 62,930 women had breast reconstruction.
Even though medical, surgical, and radiation therapy treatments for breast cancer have increased the number of breast-sparing procedures available, some breast cancer patients may still require a mastectomy (removal of the breast or breasts). In addition, other women have their breast(s) removed due to other diseases.
Breast reconstruction surgery involves creating a breast mound that comes as close as possible to the form and appearance of the natural breast.
The goal of reconstructive surgery is to create a breast mound that matches the opposite breast and to achieve symmetry. If both breasts have been removed, the goal of breast reconstructive surgery is to create both breast mounds approximately the size of the patient's natural breasts.
What are the criteria for breast reconstruction surgery?
In general, all women undergoing a mastectomy are candidates for immediate or delayed breast reconstruction. However, there are criteria for selecting the best candidates for the procedure, including the following:
The size and location of the cancer, as this helps to determine the amount of skin and tissue to be removed in the mastectomy (a primary factor when making recommendations for reconstruction)
Whether tissue has been damaged by radiation therapy or aging, and is not sufficiently healthy to withstand surgery
Other considerations include the following:
Potential for complications
The amount of tissue removed from the breast
The health of the tissue at the planned operation site
Whether radiation therapy is part of treatment
The patient's general health and physique
Past medical history
Other risk factors such as cardiac disease, diabetes, smoking, and obesity
When is breast reconstruction surgery performed?
The patient is usually educated and counseled in breast reconstructive possibilities prior to mastectomy, so that she can make the decision for or against reconstruction before going into surgery.
Based on the personal medical history of each patient, a recommendation will be made for either of the following:
Immediate reconstruction—reconstructive surgery performed at the same time as mastectomy.
Delayed reconstruction—a second operation (to reconstruct missing breast tissue) is performed after recovery from the mastectomy is complete. If chemotherapy is part of the treatment protocol, the surgeon may recommend delayed reconstruction.